SEC Form 4 · accession 0000904454-17-000580
Clovis Oncology, Inc. · CLVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James C Blair
Director
Period of report
Aug 16, 2017
Accepted (ET)
Aug 18, 2017 · 4:14 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001466301
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Aug 16, 2017 | J | 92,518 | $0.00 | D | 0 | I | By One Palmer Square Associates VII, LLC |
| Common StockF1 | Aug 16, 2017 | J | 4,835 | $0.00 | A | 7,020 | D | |
| Common StockF1,F3 | Aug 16, 2017 | J | 6,477 | $0.00 | A | 9,404 | I | By Susan W. and James C. Blair Family L.P. |
| Common StockF2 | holding | — | — | — | 1,000,000 | I | By Domain Partners VII, L.P. | |
| Common StockF2 | holding | — | — | — | 17,056 | I | By DP VII Associates, L.P. | |
| Common StockF2 | holding | — | — | — | 32,760 | I | By Domain Associates, LLC |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Distribution of shares in kind by One Palmer Square Associates VII, LLC to its members.
- F2The Reporting Person is a managing member of One Palmer Square Associates VII, LLC, the sole general partner of Domain Partners VII, L.P. and DP VII Associates, L.P., and of Domain Associates, LLC. Pursuant to Instruction 4(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities owned by each such entity, however he disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him.
- F3The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.